Abstract Body: Background: Emotional distress in cardiac arrest survivors and their caregivers (dyads) is prevalent, persistent, and undermines clinical and quality of life outcomes. To date, there is an absence of interventions that address early distress to prevent chronicity.
Aim: To inform psychosocial intervention content for new cardiac arrest survivor-caregiver dyads.
Methods: Between September 2023 and March 2024, we conducted semi-structured interviews with consecutively admitted cardiac arrest survivor-caregiver dyads from Massachusetts General Hospital early after the survivor’s cardiac arrest (i.e., during the survivor’s index hospitalization or within 1 week of discharge). We audio recorded interviews, transcribed them verbatim, and conducted hybrid deductive-inductive thematic analysis of the transcripts. At least one member of the dyad must have screened positive for emotional distress (i.e., >8 on either subscale of the Hospital Anxiety and Depression Scale). The survivor must have demonstrated sufficient cognitive status for meaningful participation (i.e., >4 on the Short Form Mini Mental State Exam). We prespecified 4 supraordinate domains of inquiry: 1) stressors and psychosocial treatment needs, 2) coping methods, 3) reactions to preliminary content that we presented during the interview, and 4) barriers and facilitators to participation in psychosocial interventions early after cardiac arrest.
Results: Dyads (N=13; survivors: female 31%, non-Hispanic White 69%, out-of-hospital cardiac arrest 62%; caregivers: female 77%, non-Hispanic White 62%, spouse/romantic partner 77%) overwhelmingly reported a need for anticipatory guidance and coping skills to address uncertainty, trauma, existential distress, and post-arrest sequelae (Domain 1). To cope (Domain 2), dyads reported utilizing social support, distraction, mind-body techniques, gratitude, and meaning and purpose. After we previewed preliminary content (Domain 3), dyads recommended we prioritize anticipatory guidance and family distress throughout. Regarding barriers and facilitators (Domain 4), dyads suggested interventions be low burden and begin after medical stabilization.
Conclusions: Early after cardiac arrest, distressed survivor-caregivers dyads recommend that psychosocial interventions include anticipatory guidance, coping skills training, be low-burden, and begin after medical stabilization. Our findings can inform various early psychosocial intervention approaches for survivors and caregivers.